Stay Well This Summer toolkit 2019 Last updated MAY 2019 to be reviewed September 2019

Stay Well This Summer Toolkit 2019

For most people the summer is an enjoyable time - a chance to get outdoors and be

active, hopefully enjoy some good weather and spend time with friends and family.

But we know that there are some risks associated with activities that are more

common during the summer - and even the weather can have an impact on our

health.

Stay Well This Summer is not a PHE campaign, but we have put together this toolkit

to provide easy access to resources available to help stakeholders and partners

prepare for and advise the public about three themes relating to summer activities

and events that may have an impact on the health of the population.

These are: (and there will be crossover between the themes in some cases)

1. Sun and heat

2. Recreation / festivals

3. Environmental / outdoor

There will be key messages and links to other resources for topics within these

themes to help get messages to the public.

For further information, please contact the PHE East Midlands Communications

Team:

Nadine Hilliard Tel: 0115 844 1498 Mob: 07966 272 082 Email: nadine.hilliard@phe.gov.uk Natalie Bowman Tel: 0115 844 1399 Mob:07920 264 924 Email: natalie.bowman@phe.gov.uk

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Stay Well This Summer toolkit 2019 Last updated MAY 2019 to be reviewed September 2019

Contents

1. Sun and Heat ......................................................................................................... 3

1.1 Heat Health Watch ............................................................................................ 3

1.2 Heatwave Plan .................................................................................................. 3

1.3 Heat exhaustion and heatstroke ....................................................................... 3

1.4 Dehydration ....................................................................................................... 3

1.5 Sun safety ......................................................................................................... 4

1.6 UV ..................................................................................................................... 4

2. Recreation - including festivals ............................................................................... 5

2.1 Food preparation and poisoning ....................................................................... 5

2.2 Fruit and vegetable preparation ........................................................................ 5

2.3 Carbon monoxide poisoning ............................................................................. 5

2.4 Sexual health/STIs ............................................................................................ 5

2.5 Drugs ................................................................................................................ 6

2.6 Alcohol .............................................................................................................. 6

2.7 Infectious diseases ........................................................................................... 6

2.8 Measles/Mumps/MMR ...................................................................................... 7

2.9 Festivals ............................................................................................................ 8

3. Environmental / outdoor ......................................................................................... 9

3.2 Reservoir / lake swimming ................................................................................ 9

3.3 Physical activity challenges ............................................................................... 9

3.4 Ticks................................................................................................................ 10

3.5 Giant Hogweed ............................................................................................... 10

3.7 Petting farms and animals that have just given birth ....................................... 11

3.8 Air pollution ..................................................................................................... 11

3.9 Travel .............................................................................................................. 12

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Stay Well This Summer toolkit 2019 Last updated MAY 2019 to be reviewed September 2019

1. Sun and Heat

The following topics relate to the potential dangers from the sun.

1.1 Heat Health Watch

The Heat Health Watch Service is operated In England by the Met Office from 1

June to 15 September each year in association with Public Health England. It is

designed to help healthcare professionals manage periods of extreme temperature.

The Met Office forecasts day-time and night-time maximum temperatures, which are

monitored regionally. When certain heat thresholds are passed, a warning is issued

and sent to relevant health professionals and people working in social care as well

as displayed on the Met Office’s website. This enables health professionals to take

action to minimise the impact of the heat on people's health.

The heat health watch forecast can be seen at -

https://www.metoffice.gov.uk/public/weather/heat-health/#?tab=heatHealth

To accompany the heat health watch service, Public Health England has prepared

its ‘Hot weather alerts communications toolkit.’

This toolkit contains pre-prepared key messages, social media updates and statements that can be used, according to the alert level in place at the time. Your regional PHE communications team will be in touch if thresholds are met and will inform you of any action that may need to be taken.

Heat Health Alerts

Comms Toolkit 2019 FINAL.docx

1.2 Heatwave Plan

The Heatwave Plan for England is intended to protect the population from heat-

related harm to health and can be found online:

https://www.gov.uk/government/publications/heatwave-plan-for-england

1.3 Heat exhaustion and heatstroke

Information and advice for the public on heat exhaustion and heatstroke can be

found on nhs.uk – https://www.nhs.uk/conditions/heat-exhaustion-heatstroke/

1.4 Dehydration

Dehydration means your body loses more fluids than you take in. If it isn't treated it

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Stay Well This Summer toolkit 2019 Last updated MAY 2019 to be reviewed September 2019

can get worse and become a serious problem. Babies, children and the elderly are

more at risk of dehydration.

Further information and advice for the public on dehydration can be found on nhs.uk

– https://www.nhs.uk/conditions/dehydration/

1.5 Sun safety

Information and advice for the public on sun safety can be found on nhs.uk –

https://www.nhs.uk/live-well/healthy-body/sunscreen-and-sun-safety/

Sun safety for babies

Information specifically for babies is also on nhs.uk – https://www.nhs.uk/common-

health-questions/childrens-health/how-can-i-keep-my-baby-safe-during-hot-weather/

1.6 UV

PHE operates a network of nine broadband UV monitoring stations in the UK and

three overseas.

The monitoring stations record hourly updates of the level of UV measured which are

then posted on Defra’s UK-AIR website - https://uk-air.defra.gov.uk/data/uv-index-

graphs.

The video The dangers of UV on our health’ is available on YouTube and may be

useful to link to during times of high UV:

https://www.youtube.com/watch?v=cblhrVTnZUU

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Stay Well This Summer toolkit 2019 Last updated MAY 2019 to be reviewed September 2019

2. Recreation - including festivals

2.1 Food preparation and poisoning

The Food Standards Agency have lots of information and advice on their website

around food preparation and handling.

There are pages about bacteria that cause food poisoning:

Campylobacter – https://www.food.gov.uk/safety-hygiene/campylobacter

Listeria – https://www.food.gov.uk/safety-hygiene/listeria

Salmonella – https://www.food.gov.uk/safety-hygiene/salmonella

Hepatitis E virus – https://www.food.gov.uk/safety-hygiene/hepatitis-e-virus

E. coli – https://www.food.gov.uk/safety-hygiene/e-coli

2.2 Fruit and vegetable preparation

It is important to wash all fruit and vegetables before you eat them to ensure they are

clean and safe to eat. Most people are aware of the importance of handling meat

safely, but many consider the risk of food poisoning from vegetables to be low.

NHS.uk also has information about how to correctly prepare fruit and vegetables –

https://www.nhs.uk/live-well/eat-well/how-to-wash-fruit-and-vegetables/

2.3 Carbon monoxide poisoning

Carbon monoxide is a poisonous gas that has no smell or taste. Breathing it in can

make you unwell, and it can kill if you're exposed to high levels. Every year there are

around 25 deaths from accidental carbon monoxide poisoning in England and

Wales. https://www.nhs.uk/conditions/Carbon-monoxide-poisoning/

2.4 Sexual health/STIs

Resources for PHE’s ‘Protect against STIs’ campaign can be found on the PHE

Campaign Resource Centre –

https://campaignresources.phe.gov.uk/resources/campaigns/68-sexual-

health/resources

There is also information on STIs on nhs.uk –

https://www.nhs.uk/conditions/sexually-transmitted-infections-stis/

The Terrence Higgins Trust also has information about HIV and STIs –

https://www.tht.org.uk/

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Stay Well This Summer toolkit 2019 Last updated MAY 2019 to be reviewed September 2019

2.5 Drugs

Information and advice about illegal drugs can be found on the Talk to Frank website

- http://www.talktofrank.com/

2.6 Alcohol

Alcohol misuse

Alcohol misuse means drinking excessively – more than the lower-risk limits of

alcohol consumption. Alcohol consumption is measured in units. A unit of alcohol is

10ml of pure alcohol, which is about:

half a pint of normal-strength lager

a single measure (25ml) of spirits

A small glass (125ml) of wine contains about 1.5 units of alcohol.

To keep your risk of alcohol-related harm low, the NHS recommends:

not regularly drinking more than 14 units of alcohol a week

if you drink as much as 14 units a week, it's best to spread this evenly over

three or more days

if you're trying to reduce the amount of alcohol you drink, it's a good idea to

have several alcohol-free days each week

Regular or frequent drinking means drinking alcohol most weeks. The risk to your

health is increased by drinking any amount of alcohol on a regular basis.

Further information on alcohol misuse is on nhs.uk –

https://www.nhs.uk/conditions/alcohol-misuse/

Alcohol poisoning

Alcohol poisoning occurs when a person drinks a toxic amount of alcohol, usually

over a short period of time (binge drinking).

Being poisoned by alcohol can damage your health or even put your life in danger.

It's important to avoid misusing alcohol and to be aware of how much you're drinking

and the effect this could have on your body.

More information on alcohol poisoning – https://www.nhs.uk/conditions/alcohol-

poisoning/

2.7 Infectious diseases

There are many infectious diseases that can affect the population at any time, travel

can also increase the risk of some of these diseases.

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Stay Well This Summer toolkit 2019 Last updated MAY 2019 to be reviewed September 2019

The PHE Infectious Diseases page has links to further information about many

infectious diseases - https://www.gov.uk/topic/health-protection/infectious-diseases.

2.8 Measles/Mumps/MMR

There continues to be an increase in cases of measles and mumps across England,

particularly in young people over the age of 15 years. There are also several large

measles outbreaks across Europe.

Measles is a highly infectious viral illness that can sometimes lead to serious

complications. It can be more severe in teenagers and adults than in children.

The best source of information about measles is on nhs.uk –

https://www.nhs.uk/conditions/measles/

Mumps

Mumps is most recognisable by painful swellings at the side of the face under the ears.

There is more information about mumps on nhs.uk - https://www.nhs.uk/conditions/mumps/

MMR toolkit for festivals

Mass gathering events like festivals can be hot spots for measles as they present the

perfect opportunity for the infection to spread.

A toolkit has been prepared to assist festival organisers in getting messages to

festival-goers before they attend the festivals including suggested tweets, messages

and links to resources such as posters.

Festival MMR toolkit

2019.docx

Value of Vaccines

Value of Vaccines is a PHE led communications campaign with the aim to maintain

high coverage in the childhood immunisations programme and reverse any

downward trends in uptake.

It comes at a time when there is increased media and political interest around ‘anti-

vax’ groups and movements, so the campaign also aims to remove the

circumstances in which anti-vaccine groups’ activity can flourish (but the strategy

remains not to tackle these groups head-on – we know that sharing a platform with

anti-vaxxers gives them credibility and a voice that they do not warrant).

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Stay Well This Summer toolkit 2019 Last updated MAY 2019 to be reviewed September 2019

There is more information in the document below, or contact PHE regional

communications.

Value_of_vaccines_ca

mpaign_brief.pdf

Value of Vaccines MMR festival graphics:

https://publichealthengland-

immunisati.box.com/s/ysjgahbuicyc19iq3esomeczsaekwr0p

https://bit.ly/2QT7jcZ

Value of Vaccines timeline animation:

https://publichealthengland-

immunisati.box.com/s/qliyea3052vxvsdqyjysxlmg160yagj6

https://bit.ly/2XA9h4C

General VoV assets:

https://publichealthengland-

immunisati.app.box.com/s/2lneh197tag7ltnbqo5nhg78pgqb5n15

2.9 Festivals

There are hundreds of festivals taking place throughout the summer, but large

gatherings of people can also mean health risks. Festival Medical Services have put

together information and advice for those attending festivals to stay safe.

https://www.festival-medical.org/health-advice

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Stay Well This Summer toolkit 2019 Last updated MAY 2019 to be reviewed September 2019

3. Environmental / outdoor

3.1 Open water swimming

This activity is growing in popularity in the UK but open water swimming can

increase the risk of gastrointestinal infections (diarrhoea and/or vomiting) as well as

respiratory, skin, ear and eye infections. Most symptoms of these illnesses will

generally be mild, caused by organisms such as norovirus, giardia and

cryptosporidium. However, there is also a risk of more severe infections caused by

organisms such as E. coli O157 which may cause severe gastrointestinal illness and

leptospirosis, which can cause liver and kidney problems.

There is a PHE leaflet about open water swimming (swimming in lakes, rivers and

reservoirs) – https://www.gov.uk/government/publications/swim-healthy-leaflet

Advice – https://www.gov.uk/government/news/new-guidance-on-reducing-the-risk-

of-illness-when-open-water-swimming

3.2 Reservoir / lake swimming

The East Midlands is served by several water companies, some of which have

prepared information and advice for the public about the dangers of reservoir and

lake swimming. The key messages from these resources are:

Swimming in reservoirs is dangerous. These are operational sites and even

the strongest swimmers can get into serious difficulties.

Reservoirs are incredibly deep in places, but very shallow in others –

particularly as water levels drop over the summer – making jumping in or

swimming extremely dangerous.

The water temperature stays very low and can cause shock or hypothermia.

The water also hides other dangers such as machinery, sudden dips and

drops, weeds and mud, and very strong currents created by the changing

3.3 Physical activity challenges

Throughout the year, thousands of people participate in extreme physical activity

challenges such as Tough Mudder, competing in such challenges may expose

participants to a number of health risks. Tough Mudder have prepared this webpage

with advice for those taking part in their challenges - other organisers of similar

events may have done the same: https://toughmudder.co.uk/content/event-safety.

If local authorities are aware of an event taking place in their area, it might be useful

to share this link ahead of the event, especially if the weather is due to be hot or

reaching alert levels.

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Stay Well This Summer toolkit 2019 Last updated MAY 2019 to be reviewed September 2019

3.4 Ticks

Ticks are small, spider like creatures that feed on the blood of animals, including

people. During this feeding process, they can transmit pathogens that can result in

infections such as Lyme Disease.

There is a dedicated page of resources including a toolkit to raise awareness of the

potential risks created by ticks and tick-borne disease in England.

The page also includes a useful video, posters, leaflets and information about the

tick surveillance scheme – https://www.gov.uk/government/publications/tick-bite-

risks-and-prevention-of-lyme-disease

3.5 Giant Hogweed

Although an impressive sight when fully grown, giant hogweed is invasive and

potentially harmful. Chemicals in the sap can cause photodermatitis or

photosensitivity, where the skin becomes very sensitive to sunlight and may suffer

blistering, pigmentation and long-lasting scars. For more information visit –

https://www.rhs.org.uk/advice/profile?pid=458

3.6 Blue-Green Algae

Blue-green algae are a type of bacteria (called cyanbacteria) that share some of the

same characteristics as plants. Blue-green algae exist all over the world and are

found naturally in many inland waters, estuaries and the sea.

The algae are very small and can’t be seen with the naked eye unless they are

concentrated into clumps when they can look like green flakes, greenish bundles or

brown dots in the water.

What are the health risks?

Blue-green algae are capable of producing several different toxins. People may be

exposed to these toxins through contact with the skin (e.g. when swimming), through

inhalation (e.g. when motor boating or water skiing), or by swallowing contaminated

water.

These toxins can cause skin rashes, nausea, vomiting, stomach pains, fever and

headaches. Occasionally they can cause more serious illness such as liver and brain

damage. Children are at greater risk than adults of developing problems because of

their comparative lower body weight.

How can the health risks be minimised?

Not all blue-green algae blooms and scums are toxic but it is not possible to tell from

appearance and so it’s best to assume they are harmful and take the following

precautions:

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Do not swim in the water

Do not swallow the water

Avoid contact with the algae

Do not eat fish caught from the water

Observe and abide by any warning notices positioned around the water

Anyone who has come into contact with water containing blue-green algae should

shower with fresh water immediately. Anyone who has come into contact with

affected water and has become ill should obtain medical attention.

The toxins which may be produced by algae are also poisonous to animals and can

cause severe illness and death. Farmers and pet owners should ensure that their

animals do not have access to affected water. For more information visit –

http://www.wales.nhs.uk/sitesplus/888/page/53916

3.7 Petting farms and animals that have just given birth

Visiting a farm is an enjoyable and educational experience for many people,

particularly children. However, such visits can never be free from all risks. Farm

animals may carry a number of infections that can be harmful to people, and so

farms that are open to the public are expected to provide hand washing facilities and

urge all visitors to wash their hands thoroughly after visiting and before eating food.

In order to protect their own health and that of their unborn child, women who are, or

who may be, pregnant should be advised to avoid close contact with livestock

animals.

PHE have produced leaflets that include information on:

how to avoid infection

what to do if you feel unwell

the risks of E. coli O157

Farm visits: avoiding infection leaflet –

https://www.gov.uk/government/publications/farm-visits-avoiding-infection

Leaflet with advice for pregnant women – https://www.gov.uk/guidance/pregnancy-

advice-on-contact-with-animals-that-are-giving-birth

3.8 Air pollution

PHE provides advice to the Department for Environment, Food and Rural Affairs

(DEFRA) on the health effects of air pollution. Whilst most people will not be affected

by short term peaks in air pollution, some individuals, particularly vulnerable groups

such as those with existing heart or lung conditions, may experience increased

symptoms.

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Stay Well This Summer toolkit 2019 Last updated MAY 2019 to be reviewed September 2019

Up-to-date information on air pollution levels and related health advice for specific

area can be obtained via the Defra website http://uk-air.defra.gov.uk, or by calling

Defra’s freephone helpline on 0800 556677.

3.9 Travel

Many people will leave the UK for their summer holiday, which may include some

potential risks.

A list of travel health questions can be found on nhs.uk –

https://www.nhs.uk/common-health-questions/travel-health/

An A-Z of countries with advice and information for travellers can be found on the

Foreign Office’s travel advice page – https://www.gov.uk/foreign-travel-advice

The National Travel Health Network and Centre (NaTHNaC) website also has health

information and advice for travellers – https://travelhealthpro.org.uk/factsheets